Length of Stay in Hospice Care across Racial/Ethnic Minorities over 65 Years of Age: A Descriptive Analysis

Abstract Purpose This study aims to explore the relationship between race/ethnicity and length of stay in hospice care among adults over 65 years of age in the United States. This topic is understudied within a population-representative sample, particularly among non-White decedents. Methods Secondary analysis of data from the 2007 NHHCS (n=3,918). Race/ethnicity included Hispanics/Latinos, Non-Hispanic Whites, African Americans, and other races. Length of hospice stay was measured by the number of days that patients received hospice care from hospice agencies. Results The study found that African Americans have a longer length of stay in hospice agencies than Whites, even after controlling for all other factors in the model. Female gender, older age, and several diseases are covariates that significantly impact length of hospice stay. Discussion Compared to other races/ethnicities, the long length of stay in hospice among African Americans may negatively impact the quality of end-of-life care and quantity of skilled staff visits. Future research is recommended to further explore potential consequences of longer hospice stays, especially within African American communities. Studies with larger samples of minorities that integrate socioeconomic factors need to be done to better study the relationship between length of hospice stay and race/ethnicity.


LENGTH OF STAY IN HOSPICE CARE ACROSS RACIAL/ETHNIC MINORITIES OVER 65 YEARS OF AGE: A DESCRIPTIVE ANALYSIS
Heshuo Yu, 1 and J. Scott Brown, 2 , 1. Miami University in Oxford,Oxford,Ohio,United States,2. Miami University,Oxford,Ohio,United States Purpose: This study aims to explore the relationship between race/ethnicity and length of stay in hospice care among adults over 65 years of age in the United States. This topic is understudied within a population-representative sample, particularly among non-White decedents.
Methods: Secondary analysis of data from the 2007 NHHCS (n=3,918). Race/ethnicity included Hispanics/ Latinos, Non-Hispanic Whites, African Americans, and other races. Length of hospice stay was measured by the number of days that patients received hospice care from hospice agencies.

Results:
The study found that African Americans have a longer length of stay in hospice agencies than Whites, even after controlling for all other factors in the model. Female gender, older age, and several diseases are covariates that significantly impact length of hospice stay.
Discussion: Compared to other races/ethnicities, the long length of stay in hospice among African Americans may negatively impact the quality of end-of-life care and quantity of skilled staff visits. Future research is recommended to further explore potential consequences of longer hospice stays, especially within African American communities. Studies with larger samples of minorities that integrate socioeconomic factors need to be done to better study the relationship between length of hospice stay and race/ethnicity.

OLDER COUPLES' ADVANCE CARE PLANNING ENGAGEMENT PATTERNS AND ASSOCIATIONS WITH INDIVIDUAL AND SPOUSAL FACTORS
Hyo Jung Lee, 1 and Bon Kim, 2 , 1. Nanyang Technological University, Singapore, Not Applicable, Singapore, 2. Jeju National University, Jeju-si, Cheju-do, Republic of Korea This study examines older couples' dyadic patterns of informal and formal advance care planning (ACP) and determines the associations of these patterns with their own and spousal characteristics. Using data from the 2014 and 2016 Health and Retirement Study, we performed a) latent class analysis to identify distinctive ACP engagement patterns and b) multinomial regression models to describe related characteristics of older couples (N = 1,545 couples). We identified four dyadic patterns of ACP engagement: a) high ACP engaging couple (45%); b) high engaging husband -low engaging wife (13%); c) high engaging wifelow engaging husband (11%); and d) low engaging couple (31%). Engagement in informal and formal ACP was associated with both individual and spousal factors: Older couples with advanced age or higher levels of education and wealth were more likely to engage in both informal and formal ACP, whereas only wife's high level of constrain or husband's greater number of depressive symptoms was associated with discordant ACP engagements. Couple-based approach to promote ACP merits older couples with limited resources or poorer psychological health in both or either spouse.

PALLIATIVE CARE KNOWLEDGE AND PLANNING IN U.S. ADULTS
Amy Albright, 1 and Rebecca Allen, 2 1. VA Maine HCS,Gorham,Maine,United States,2. University of Alabama,Tuscaloosa,Alabama,United States Palliative care knowledge and health literacy are frequently underestimated in American adults; for example, as measured by the Newest Vital Sign (Weiss et al., 2005), 79.2% (n = 247) of participants within a Geriatrics Clinic sample displayed "adequate" functional health literacy, while 11.8% (n = 37) scored within the "possibly limited" range, and 9.0% (n = 28) scored within the "highly limited" range. There was additionally a significant association between health literacy and age (r = .15, p < .01) within this sample. The Palliative Care Knowledge Scale (PaCKS; Kozlov et al., 2018) was administered to participants, and higher scores indicated a greater knowledge of palliative care. This construct is particularly important to measure, as racial/ethnic 778 Innovation in Aging, 2021, Vol. 5, No. S1 GSA 2021 Annual Scientific Meeting